Organization
COMMUNITY SUPPORTS PROGRAMMING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA MARIE MANNION RN (REGISTERED NURSE)
(320) 629-6674
Entity
Organization
Contact information
Practice address
500 3RD AVE SE STE 2, PINE CITY, MN 55063-1544
(320) 629-6674
(320) 629-6630
Mailing address
500 3RD AVE SE STE 2, PINE CITY, MN 55063-1544
(320) 629-6674
(320) 629-6630
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
A486667300
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A486667300
STATE PROVIDER #
MN
Enumeration date
12/31/2008
Last updated
12/31/2008
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